ART Attrition across Health Facilities Implementing Option B+ in Haiti

Journal of the International Association of Providers of AIDS Care
Martine MyrtilKesner François

Abstract

Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.

References

Jan 29, 2014·AIDS·Lyson TenthaniUNKNOWN Ministry of Health in Malawi and IeDEA Southern Africa
Dec 2, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Mary Pat KiefferUNKNOWN EGPAF Technical Directors Forum
Apr 28, 2016·Journal of the International AIDS Society·Pascal GeldsetzerTill Bärnighausen
May 22, 2016·Tropical Medicine & International Health : TM & IH·Jara Llenas-GarcíaUNKNOWN SolidarMed and IeDEA-Southern Africa

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